Brent Saunders, the chief executive of Allergan, one of the largest pharmaceutical firms in the world, is concerned that in an era of increasing political polarization, Americans will become fed up and embrace the single-payer health care plan set to be unveiled Wednesday by Sen. Bernie Sanders, I-Vt.

He shared his candid thoughts last weekend at the Wells Fargo Healthcare Conference in Boston, a gathering for investors and major pharmaceutical and biotech firms.

Americans have lost trust in drug companies, Saunders said, noting the industry consistently ranks lower than oil and tobacco companies in public trust surveys.

“I think we’ve got to do things to bring that trust back,” the executive added, “because ultimately, someone’s going to be in the White House. Somebody’s going to be in Congress. Someone’s going to be somewhere and going to have to say, ‘Enough’s enough. Let’s just change the whole system. Let’s go to one payer. Let’s do something.'”

While single payer has been discarded as a fringe, far-left idea over recent generations, the policy proposal has gained new traction in the wake of the 2016 presidential election. Many in the Democratic Party are drifting to the ideas of Sanders and other progressives who have long advocated for expanding coverage by providing Medicare to all Americans.

Saunders observed that “the party that seems to be out of power tends to move dramatically to the left or to the right,” adding that the Republican Party during the Obama era had lurched more right-wing.

“We’re seeing almost the equal but opposite reaction here now that they’ve been swept out, the left of their party is really taken, gotten a louder voice and taken control,” Saunders continued, speaking about changes in the Democratic Party.

“And so Bernie Sanders and others in that movement had really tried to vet candidates,” Saunders noted, adding, “They wanted to go to one — that part of the party wants to go to a one-payer system.”

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During his speech, Saunders touted a statement of principles he released in 2016 calling for a “social contract” with patients, promising not to use predatory pricing and other behaviors that have come to define his industry.

But if Saunders is concerned that the public may get fed up with the current system, it may have something to do with how Allergan itself has acted in recent weeks. The CEO has been under fire for taking the unprecedented step of transferring the patent of one of Allergan’s blockbuster drugs, the eye medication Restasis, to a sovereign Native American tribe as part of a bid to maintain monopoly control of the drug and its revenue.

The highly unusual legal strategy is designed to keep generic drug firms from challenging the Restasis patent, thus lowering the cost to consumers, while keeping Allergan in effective control of the revenue through its deal with the Saint Regis Mohawk Tribe. The Restasis patent was approved 15 years ago and was set to expire in 2014, but the Allergan deal is part of an attempt to renew the patent and extend the company’s control of the drug through 2024.

While serious questions linger about the political viability of single payer, especially for the immediate future under President Donald Trump and a Republican Congress, the center of gravity within the Democratic Party has shifted dramatically in favor of the universal Medicare plan that health care executives fear.

Top photo: People rally calling for a single-payer health plan on June 28, 2017, in Sacramento, Calif.

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